And now a word from our pharmaceutical manufacturer

One of the first things British visitors to the US seem to notice on television is the advertising. It may have something to do with the higher frequency of ad spots, particularly at prime time, and it may be that ads air at a higher volume than the programmes they support. And while it’s dangerous to over-generalise, American creative tends to be more direct and to the point than those that show in the UK. But while most British visitors and expatriates soon get used to American ads, a lot of people I know are still thrown by one genre: pharmaceuticals.

In a 60-minute late-night viewing period on a recent Sunday night, I counted six drug ads championing products such as Lipitor, Fosamax and Ambien. It’s easy to understand why people from the UK are left bemused, as a good number of the campaigns are pushing prescription drugs. In fact, the US and New Zealand are the only industrialised countries where this type of advertising is allowed.

US drug ads are part sales pitch and part educational lesson, but sometimes, like a lot of consumer advertising everywhere, they seem to tap into the viewer’s insecurities. A friend of mine who recently moved to New York from London joked over dinner about a cortisol reduction ad which seems to identify her in person. It asks: “Are you female and over 30? Are you overworked and stressed? Do you have unwanted belly fat?” She had no idea what cortisol was but seriously thought about getting the drug that would cure her of it.

My personal favourites are the drugs for a disease called “ED”. Call it schoolboy humour, but it’s hard not to suppress a giggle as the handsome middle-aged men smile happily, while their female partners talk earnestly about how said drug changed their lives by curing him of ED – which is, of course, erectile dysfunction.

Then there’s the ad with the alluring female actress who shatters the healthy walks-on-the-beach illusion by explaining how the drug she’s taking has helped her get on with her life despite having genital herpes.

But there really couldn’t be a more serious business than pharmaceutical marketing, which has had a short but eventful life involving Capitol Hill, pharmaceutical lobby groups and the advertising industry.

Direct-to-consumer (DTC) drug advertising, as it is known here, formally started on television ten years ago after the government agency Food and Drugs Administration (FDA) relaxed the rules to allow the ads on air. Those with longer memories note that some of the first DTC advertising actually started back in 1983. A British company, Boots Pharmaceuticals, was said to have run one of the first ads – for its then prescription-only ibuprofen product, branded Rufen.

Later that year the FDA asked for a moratorium on drug ads, leading eventually to where the industry is now. DTC advertising has ballooned from a mere $12m in 1996 to $4.2bn (£2.2bn) today, according to industry bodies, and is still one of the fastest-growing sectors. Ad industry estimates forecast DTC advertising will break the $5bn (£2.6bn) mark by the end of 2006 after posting a 40% increase in spend for the first half of the year, according to TNS Media Intelligence data.

The overall US drug advertising market was worth $11.4bn (£6bn) last year when you include the professional marketing of drugs, such as sales reps marketing to doctors.

The most advertised drug last year was a sleeping remedy called Lunesta made by Sepracor. The company upped its spend nearly fourfold for the first half of the year to more than $160m (£84m). Reports say Sepracor had been expecting the marketing campaign for a new rival sleeping drug from Pfizer to help increase awareness, but that drug was never launched, so Sepracor upped the Lunesta marketing budget.

The next most advertised drug is also a sleeping aid, Ambien, from Sanofi-Aventis, which more than doubled its budget to $113.8m (£60.2m).

These sort of sums probably make the UK marketing fraternity, particularly on the agency side, green with envy. But even here, in the home of free enterprise, there are concerns about whether the relaxation of those FDA rules ten years ago has allowed marketers to go too far or whether DTC ads should be allowed at all. It’s worth noting that New Zealand is looking to ban such ads.

After the euphoria that greeted Democrats being ushered into power in the House of Representatives and the Senate, people are starting to ask the difficult questions about how a possibly left-leaning Congress might impact big business – and drug advertising is one area that Capitol Hill watchers are expecting the Democrats to review. Senator Ted Kennedy, who is likely to chair the new Senate health committee, has previously criticised the FDA for not scrutinising DTC ads sufficiently. He has also co-sponsored legislation to impose a two-year moratorium on advertising a drug after its approval by the FDA.

Kennedy’s not the only one who thinks this might be the way forward. An August survey of US physicians by MedPanel found that eight out of ten favour a moratorium on advertising new drug therapies to consumers.

That should come as no surprise, as most doctors need time to get sufficient information on all the possible effects of drugs before administering them to patients. This is especially relevant in a country where healthcare is mostly private and is effectively driven by consumer demand.

Consumer advocacy group Commercial Alert has been campaigning against DTC advertising for some years. It invites consumers to sign up at its StopDrugAds.org website and to lobby their member of Congress against drug advertising.

Like financial services advertising in the UK, prescription drug ads in the US must have a brief summary of the pros and cons. One of the ways the FDA allows extra information to be shared with consumers is for all the ads to have either a freephone number and/or a website. Most also point out that you need to see your physician for a prescription.

But Commercial Alert argues that drug ads shouldn’t be allowed to display imagery that is primarily emotive and not educational. It ultimately calls for a complete ban on prescription drug advertising on TV and radio.

On the other side of the debate is PhRMA, a pharmaceuticals industry lobby group, which last year issued guidelines to its members for DTC ads. These guidelines, which took effect on January 1, emphasise, among other things, educating consumers and giving a balanced representation of the benefits and risks of taking an advertised drug.

In July, PhRMA issued a report which revealed it had received 284 comments from the public about its members’ ads. It didn’t make clear whether they were actually complaints or compliments – so industry watchers don’t know if the guidelines are having a positive effect.•